LiveCareer-Resume

health partner engagement manager resume example with 10+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
  • :
Summary

My experience has provided me with the knowledge and ability to provide outstanding customer service, excellent verbal and written communications skills. The ability to deal with the public enthusiastically. I strive to provide great collaboration with coworkers and internal department staff, interpersonal, and multitasking abilities. Highly organized, proactive and punctual with team oriented mentality. Meets tight deadlines every time. I am a motivated employee seeking the opportunities to expand skills while facilitating company growth. Flexible hard worker ready to learn and contribute to team success.

Skills
  • Certified Life Coach
  • Customer Relationship Management
  • Event planning and execution
  • Accounts payable understanding
  • Excellent interpersonal and organizational skills
  • Communication and problem solving
  • Time Management
  • Staff training and development
  • Team Building/Leadership
Experience
Health Partner Engagement Manager, 08/2020 to Current
CareSourceCity, STATE,
  • Provided input into team practices with HPRS and internal on areas in need of improvement with the assigned Health Partners to ensure that the appropriate is effectively responding in a timely manner.
  • Build excellent communication and trust with the Health Partner. Plan, schedule and facilitate monthly and quarterly meeting.
  • Active participant in all internal meetings. Work and complete assigned outreach projects. Point of contact for Health Partners to assist and advocate on their behalf to resolve concerns in a timely manner.
  • Consulted with Tier 1 Health Systems to identify internal procedures that adversely affect them, gather issues and define work practices and procedures. Provide education opportunities, webinar, systemic issues, portal training and network notifications.
  • Worked with cross-functional internal team members to manage group needs on identified issues for claims resolutions and follow up on tasks through completion..
  • Help to review and discuss identified issue, place research tickets and assist to find the root cause of concern to provide a resolution.
  • Assisted the Health partner in setting up a process and provided them with concepts to have a better workflow in submitting issues and followed through implementation.
  • Measured and reported on issues performance on volume, gained insights and compared results against the goals to reduce AR issue and to identify strengths and weaknesses.
  • Strengthened outreach communication with Health Partners and developed trust to drive interest level to add other lines of business.
  • Worked with MLSS and Delegation departments to coordinate meeting to discuss concern, identify issues that focused on successful communication and resolution for the Tier 1 Health Systems.
  • As the advocate for the Health Partner, I demonstrate the ability to handle, refer, delegate complex or non-routine question to the appropriate departments. Other duties as assigned
Health Partner Resolution Specialist, 02/2018 to 08/2020
CareSourceCity, STATE,
  • Point of contact for Health Partners to assist and advocate on their behalf. Providing account support and driving resolutions in a timely manner.
  • Communicate well with the Health Partner with the goal of the overall satisfaction and engagement of the Health Partner.
  • Submit research ticket, provide response to claims and general operational issues that the Health Partner brings to our attention.
  • Outreach to all appropriate departments for claims resolution. Follow up on tasks through completion. Work collaboratively with staff and management to ensure continuous performance improvement.
  • Resolve routine issues with the Health Partner in the market in accordance with the department service level of expectations.
  • Participate in the maintenance and development of the relationship with our Health Partners.
  • Utilized proven methods of dispute resolution by fostering understanding of opposing party's perspective. Other duties as assigned.
Senior Finance Revenue Cycle Specialist Supervisor, 05/2011 to 02/2018
University HospitalsCity, STATE,
  • Supervised team of 5 specialist. Developed team schedules, managed timekeeping and administered bi-weekly payroll for team.
  • Created and implemented the training manual and check list for new hires for the revenue cycle department. Reduced insurance revenue, audited productivity, review and analyze account balances.
  • Senior team leadership on discussion on ways to collect payment for medical services rendered from insurance companies.
  • Boosted team productivity and success by establishing strong and trusted connections.
  • Completed audits to check verifications on outreach and claim denials follow up.
  • Recruited, trained and motivated a 5 person team on time management.
  • Trained how team in handling billing and coding procedures and creating observation bill.
  • Processed cash, check and credit card payments on patient accounts.
  • Liaised with customers, addressed inquiries, handled meeting requests and answer billing questions to provide outstanding customer care.
  • Utilized active listening skills to quickly resolve problems and escalated larger issues to senior leadership.
  • Managed daily operations of mail staff by supporting continuous delivery of excellent services and care.
  • Trained employees on best practices and protocols while managing teams to maintain optimal productivity.
  • Drove client retention and increased revenue by driving effective customer relationship management protocols.
  • Promoting positive work environment through effective communication, active engagement and hands-on assistance.
Education and Training
Bachelor of Science: Education of Individuals in Elementary Special Education Programs, Expected in 06/1989 to Cleveland State - Cleveland, Ohio,
GPA:
Accomplishments
  • Recognized as Sunday school teacher of the year for outstanding performance and team contributions.
  • Mentor for teen girls ages 8-21
  • Manager-finance at Green works dance company for 6 years
  • Created highly effective new hire training manual and check list that significantly impacted efficiency and improved operations at University Hospitals.
  • Led UH revenue cycle team to achieve 4.5 million dollars in revenue, earning recognition from upper management and financial reward.

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Resume Overview

School Attended

  • Cleveland State

Job Titles Held:

  • Health Partner Engagement Manager
  • Health Partner Resolution Specialist
  • Senior Finance Revenue Cycle Specialist Supervisor

Degrees

  • Bachelor of Science

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